Postmortem findings in bone cement implantation syndrome-related deaths.

Details

Serval ID
serval:BIB_32292FBB9AF9
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Postmortem findings in bone cement implantation syndrome-related deaths.
Journal
American Journal of Forensic Medicine and Pathology
Author(s)
de Froidmont S., Bonetti L.R., Villaverde R.V., Del Mar Lesta M., Palmiere C.
ISSN
1533-404X (Electronic)
ISSN-L
0195-7910
Publication state
Published
Issued date
2014
Peer-reviewed
Oui
Volume
35
Number
3
Pages
206-211
Language
english
Notes
Publication types: Journal ArticlePublication Status: ppublish
Abstract
Several mechanisms have been postulated as potentially involved in life-threatening complications during cemented surgery. In this study, we evaluated the role of anaphylaxis and pulmonary fat embolism in the pathophysiology of bone cement implantation syndrome in a series of fatal cases that underwent medicolegal investigations. Postmortem findings in these cases were compared with those obtained from individuals who died after other injuries and/or interventions and in which activated mast cells and pulmonary fat embolism were involved in the pathogenesis of death. Fifty subjects were selected including 6 individuals who had undergone cemented total hip arthroplasty and died intraoperatively, 32 subjects who died shortly after being involved in traffic accidents, 8 individuals who died shortly after the injection of contrast material, and 4 subjects who had undergone orthopedic surgery and died postoperatively. Massive pulmonary fat embolism was determined to be the cause of death in all the 6 subjects who died intraoperatively as well as the main cause of death in traffic-road victims with rapid respiratory function deterioration. Mast cell activation was identified exclusively in the group of subjects who died shortly after contrast material administration. Massive pulmonary fat embolism appears to be the most important factor responsible for severe cardiorespiratory function deterioration during cemented arthroplasty. Cardiac comorbidities can also significantly influence the severity of intraoperative complications, thus corroborating the hypothesis of a multifactorial model in the pathogenesis of bone cement implantation syndrome.
Pubmed
Web of science
Create date
25/09/2014 16:51
Last modification date
20/08/2019 13:17
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